Going through ‘the change’ and feeling down in the dumps? You are not alone – this stage of life can take its toll on your emotional stability. Here are some common questions and answers about depression and menopause.
The good news is – not necessarily. How you experience menopause is dependent on many things – how healthy you are, whether you are taking care of yourself, whether you are happy with your life generally, and how you view your body.1 It’s a chicken-or-egg scenario – are the hormonal changes of menopause impacting on your life, or is your life impacting on how you experience menopause?
Figures show that:
Kate was coming out of postnatal depression when she started experiencing the symptoms of menopause. She says it was “very hard to cope”.
“I found the symptoms really depressing,” Kate says. “I gave birth when I was about 40 to my last child, and then I had a period of being treated for post-natal depression. I then went into perimenopause, and the depression deepened. Maybe it was the menopause causing enhanced symptoms of depression. It was a terrible, terrible time.”
For some women, menopause can bring positive changes. Janet had suffered years of debilitating symptoms from endometriosis, so welcomed the end of menstruation. She is now able to live an active life, and achieve some of her lifetime goals like climbing to Everest base camp.
“I found coming into menopause liberating,” Janet says. “I had endometriosis all my life, so my periods were horrendous, and it limited what I could do. So to stop having a period was just amazing. It gave me this freedom to go and explore.”
In her fifties, Janet took up acting and modeling, started rally car racing, climbed Mount Kilimanjaro, and got married for the first time. You can hear Janet’s story here.
The link between depression and menopause is not well understood. However, it’s the hormonal imbalance that occurs as estrogen declines that leads to changes in your brain and nervous system causing mood swings, depression, memory loss, problems focusing, and other menopausal symptoms.4
Besides the hormones having an impact on your brain, menopause can be confronting for some women, representing the end of fertility and signifying the ageing process. Laurel started experiencing menopausal symptoms that she put down to a stressful job. When her doctor suggested she was peri-menopausal, she was in denial.
“I thought, I’m only 46… I’m still young. I feel young. That happens to older women and I’m not old, so that’s actually not happening to me,” Laurel says.
“I didn’t even want to say that word, menopause. The doctor can’t be right.”
Laurel started to realise the ‘panic attacks’ were actually hot flushes. She felt anxious, and accepted it was related to menopause, not a sign that she wasn’t coping with her work. She went back to the doctor, and developed strategies for managing the symptoms.
Just to make it confusing (when your brain is already foggy), some of the symptoms of depression are similar to those of menopause, as Laurel experienced. The symptoms common to both depression and menopause include sleep problems, fatigue, irritability, weight change and anxiety. This can be confusing if you’re trying to work out whether you are depressed. It may also lead to some women thinking these problems are a natural part of ageing, and not seeking treatment. But whether you think you may be depressed or going through menopause (or both), talk to your doctor about it.
It’s important to remember that menopause is not an illness – it’s just another life stage – and that depression during this time can be treated.
Your doctor can help you deal with menopausal symptoms, including depression. They can also help you to identify if you’re suffering from more serious depression.
Plus, there are things you can do yourself to help… but what works for one person won’t necessarily work for another, so speak to your doctor about your options.
Kate tried to treat her depression by changing her lifestyle. “When I first got diagnosed with depression, I went on a journey around my health because I was pretty unhealthy,” she says.
“I used to eat a lot of really rich foods, and I drank a lot of alcohol. I didn’t exercise enough, and I ate the wrong food, so when I got depressed I started looking into my health. I wanted to have a different life.”
A healthy lifestyle is important for staying physically and mentally well through menopause. Keep up all those sensible things you should be doing to take care of yourself, such as getting enough sleep; eating well; cutting back on alcohol, caffeine and recreational drug use; avoiding stress; participating in regular exercise and maintaining a healthy weight.
Be careful not to isolate yourself. Accept social invitations and spend time with your family and friends – even if it’s the last thing you feel like doing. If you hide yourself away from the world, you’ll just end up feeling lonely, which will compound the problem.
You could also consider psychological therapy, such as cognitive behaviour therapy (CBT). CBT involves recognising the unhelpful thoughts that may be influencing depression and anxiety, and replacing them with more helpful thoughts.
Relaxation and breathing techniques and mindfulness training may also be helpful. You could also try journaling, as another way of exploring the rollercoaster of emotions that can come with menopause.
Laurel found it helped her stay calm by changing her self-talk and focusing on her breathing.
“I was snappy with the kids, and I had to think, what am I doing? Is the washing up really that important? And now that I recognise it and know it for what it is, I just think to myself, it’s okay. Just calm down now, and if the house is a little bit messy or they need a little bit more of my time than I’ve actually got, it’s okay, just chill out. The meditation, the mindfulness – just keep bringing it back, keep calming down and trying to relax a little bit so I can get through it and stay happy.”
Also, be kind to yourself. Laurel says we excuse teenagers for their swinging hormones, but aren’t always so forgiving of ourselves. “We’re so hard on ourselves,” she says. “Why?”
Medications can also help treat depression and the symptoms of menopause.
Your doctor will be able to talk to you about your options for prescription medicines and natural therapies.
Kate’s doctor prescribed Menopause Hormone Therapy (MHT) to help relieve her menopause symptoms, which included hot flushes, night sweats and headaches. Her lifestyle changes, coupled with HRT, have helped her achieve mental wellbeing. You can hear more about Kate’s story here.
However, this may not work for all women. Some serious depression may require antidepressant medication in combination with ‘talk’ therapy from a registered psychologist or psychiatrist.
The first step for taking control of your menopause symptoms and mental health, is to see your doctor. Take our menopause symptom checklist with you.
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1 Jean Hailes for Women's Health. Mental health and emotions. Available at https://jeanhailes.org.au/health-a-z/menopause/mental-health-emotions. Accessed 19 January 2018.
2 Freeman EW. Associations of depression with the transition to menopause. Menopause (New York, NY). 2010;17(4):823-7.
3 Jean Hailes for Women's Health. Menopause symptoms. Available at https://jeanhailes.org.au/health-a-z/menopause/menopause-symptoms. Accessed 19 January 2018.
4 Women's Health Research Institute. Menopause. Available at http://menopause.northwestern.edu/content/how-hormone-depletion-affects-you. Accessed 19 January 2018.